腹腔镜子宫肌瘤剥除术对子宫肌瘤患者内分泌功能、盆底功能及生育功能的影响

Effect of Laparoscopic Myomectomy on Endocrine Function,Pelvic Floor Function and Fertility Function in Patients with Hysteromyoma

目的:评价腹腔镜子宫肌瘤剥除术对于子宫肌瘤患者的临床影响。方法:将2019年2月-2021年2月十堰市茅箭区人民医院收治的88例子宫肌瘤患者按照随机数字表法分组,各44例。参考组行开腹子宫肌瘤剔除术治疗,观察组予以腹腔镜子宫肌瘤剥除术治疗,对比术前、术后6个月两组的内分泌功能、盆底功能及生育功能。结果:术后6个月,两组的雌二醇(E_(2))及抗米勒管激素(AMH)水平均较术前下降,但观察组高于参考组,差异均有统计学意义(P<0.05);卵泡刺激素(FSH)指标较术前上升,但观察组低于参考组,差异均有统计学意义(P<0.05);术后6个月两组国际女性性功能评估量表(FSFI)各项评分指标均低于术前,但观察组各指标高于参考组,差异均有统计学意义(P<0.05)。术后6个月观察组总盆底功能障碍发生率为4.55%,低于参考组的18.18%(P<0.05);随访1年内两组的妊娠率及流产率比较,差异无统计学意义(P>0.05)。结论:腹腔镜子宫肌瘤剥除术有助于改善子宫肌瘤患者内分泌功能,降低盆底功能障碍发生率,且对患者生育功能的影响较小。

Objective:To evaluate the clinical impact of laparoscopic myomectomy on patients with uterine fibroids.Method:A total of 88 patients with uterine fibroids who were admitted to People’s Hospital of Maojian District,Shiyan City from February 2019 to February 2021 were divided into two groups according to the random number table method,44 cases in each group.The reference group were treated with open myomectomy,and the observation group were treated with laparoscopy myomectomy.The endocrine function,pelvic floor function and fertility function of the two groups were compared before and 6 months after operation.Result:At 6 months after operation,the levels of estradiol(E_(2))and anti-Müllerian hormone(AMH)in both groups were lower than those before operation,but the levels in the observation group were higher than those in the reference group,the differences were statistically significant(P<0.05),and the follicle stimulating hormone(FSH)index was higher than that before operation,but the observation group was lower than that in the reference group,the differences were statistically significant(P<0.05).At 6 months after operation,the scores of the international female sexual function assessment scale(FSFI)in the two groups were lower than those before operation,but those in the observation group were higher than those in the reference group,the differences were statistically significant(P<0.05).At 6 months after operation,the incidence of total pelvic floor dysfunction in the observation group was 4.55%,which was lower than 18.18%in the reference group(P<0.05).There were no significant differences in pregnancy rate and abortion rate between the two groups within 1 year of follow-up(P>0.05).Conclusion:Laparoscopic myomectomy is helpful to improve the endocrine function of patients with uterine fibroids,reduce the incidence of pelvic floor dysfunction,and has little effect on the reproductive function of patients.